农村成人乙肝疫苗接种意愿的研究——基于保护动机理论模型

摘要:目的　基于保护动机理论模型,探讨影响农村成人乙肝疫苗接种意愿的因素。方法　在保定市2个县的6个村,采用多阶段与概率比例规模抽样结合的方法,确定1 397名研究对象,调查保护动机理论变量、社会人口经济学变量和接种意愿等内容,进行多因素回归分析。结果　在控制其他变量条件下,除易感性外,严重性、反应效能、自我效能和反应成本等保护动机理论变量对农村成人乙肝疫苗接种意愿具有影响。结论　保护动机理论模型对农村成人乙肝疫苗接种意愿具有一定解释作用,可根据其针对性设定健康教育内容和干预策略。     

慢阻肺患者流感疫苗接种意愿及影响因素调查

目的:调查扬州市某县区慢性阻塞性肺疾病(以下简称慢阻肺)患者流感疫苗接种意愿及其影响因素,为制订慢阻肺患者管理策略提供科学依据。方法:以扬州市某县区2017年慢阻肺监测数据库中的人群为研究对象,通过问卷调查的方法收集调查对象基本信息、吸烟饮酒情况、家庭情况、幸福感、流感疫苗接种意愿及实际接种情况。采用多因素logistic回归模型分析流感疫苗接种意愿的影响因素。结果:984份问卷纳入最终分析,慢阻肺人群流感疫苗接种意愿为65.1%,但近一年仅有6.5%接种过流感疫苗。多因素logistic回归分析结果表明,与目前不吸烟、近一年未接种过流感疫苗、自我感觉不幸福者相比,目前吸烟(OR=1.74,P=0.005)、近一年接种过流感疫苗(OR=4.16,P<0.001)、自我感觉一般/幸福/非常幸福的慢阻肺患者(OR_一般=1.86,P=0.036;OR_幸福=1.93,P=0.023;OR_非常幸福=2.21,P=0.026)具有更强的接种意愿。不愿接种流感疫苗的原因主要是接种费用问题和对流感疫苗缺乏认识。结论:慢阻肺患者流感疫苗接种率很低,应通过实施免费接种政策、加大宣传力度和提升幸福感等方式提高接种率,从而保障慢阻肺患者的健康。     

基于健康信念模式的带状疱疹疫苗接种意愿及其影响因素研究北大核心

目的了解中国6个城市居民带状疱疹疫苗的接种意愿,分析影响接种意愿的因素,为制定带状疱疹疫苗接种相关的干预措施,提高老年人带状疱疹疫苗接种意愿提供依据。方法在全国6个城市中,每个城市选取4个社区,选取年龄≥40岁的当地居民,自拟《带状疱疹疫苗接种意愿及其影响因素调查表》进行问卷调查,采用二元Logistic回归分析方法,分析带状疱疹疫苗接种意愿的影响因素。结果共有1517名调查对象完成问卷调查(有效率98.7%);90.1%(n=1367)的调查对象表示愿意为自己接种带状疱疹疫苗。二元Logistic回归分析显示,对于接种行为益处(OR=1.58,95%CI:1.41~1.75)、疾病易感性(OR=2.77,95%CI:2.55~2.99)以及提示因素(OR=3.87,95%CI:3.65~4.09)的感知对疫苗接种意愿具有促进作用。对于主观障碍(OR=0.62,95%CI:0.43~0.81)、疾病严重性(OR=0.54,95%CI:0.31~0.77)的感知会降低疫苗的接种意愿。结论当前中国居民对于带状疱疹疫苗的接种意愿较高。对于接种行为益处的感知、对于疾病易感性、严重性的感知、主观障碍以及提示因素是带状疱疹疫苗接种的影响因素。     

江苏省医护人员流感与水痘疫苗免疫现况及接种意愿

目的 了解医护人员流感、水痘疫苗的免疫现况及其接种意愿与影响因素,为提高人群接种率提供依据。方法 采用随机分层抽样方法,抽取江苏省15家医疗机构262名医护工作者进行调查,采用多因素logistic逐步回归法对其接种意愿影响因素进行分析。结果 262名医护工作者流感、水痘疫苗接种率分别为57.6%、54.6%,接种意愿率分别为60.7%、51.5%。流感疫苗：医院级别、学历、编制是接种意愿率的主要影响因素(P值均<0.05),基层医院接种率低但接种意愿最高。水痘疫苗：年龄、医院级别、学历、岗位类别是接种意愿的主要影响因素(P值均<0.05)。不愿接种原因前2位是觉得疫苗有效期短效果不佳、疾病症状不严重。结论 江苏省医护人员流感、水痘疫苗接种率较低,接种意愿有待提高。     

西南某市未接种流感疫苗老年人群的知信现状与接种意愿的影响因素研究

目的 了解目前西南某市未接种流感疫苗老年人群对流感疫苗的知信现状和接种意愿,分析影响该老年人群接种意愿的因素,为推进流感疫苗普及提供依据。方法 收集某市2023年10—12月600例60岁及以上未接种流感疫苗的老年人对流感疫苗相关知识的知信现状与接种意愿,最终有效问卷538份。采用t检验和χ2检验进行单因素分析,流感疫苗接种意愿的多因素分析采用logistic回归模型。结果 538例老年人中57.8%的有流感疫苗接种意愿。55.6%的老年人“不了解或没有听说过流感疫苗”;53.2%的老年人认为“流感疫苗可能没有效果”;67.5%的老年人认为“接种流感疫苗会产生副作用”,且“估计产生副作用的比例”为17.53%。流感疫苗接种意愿的多因素分析结果显示,与“没有听说过流感疫苗”组相比,“大致了解”者(OR=2.464, 95%CI:1.209～5.019, P=0.013)和“非常了解”者(OR=2.885, 95%CI:1.112～7.485, P=0.029)流感疫苗接种意愿高;与“估计60岁及以上老年人群流感疫苗的接种比例为<20%”组相比,“估计接种比例60%～80%”组(OR...     

社区慢性阻塞性肺疾病患者流感和肺炎疫苗接种意愿及影响因素

[目的]了解慢性阻塞性肺疾病(COPD)患者流感、肺炎疫苗接种意愿和影响因素,为在COPD患者中开展相关健康教育和疫苗接种推广提供参考。[方法]以浙江省宁波市3个区的629名60~74岁COPD患者为调查对象,于2013年10—11月对调查对象进行问卷调查,内容包括个人基本信息、职业和收入、疫苗接种意愿与行为等。对疫苗接种意愿的影响因素进行多因素非条件logistic回归分析。[结果]5年内流感、肺炎疫苗接种率为10.49%,有意愿自费去社区医院自行接种流感、肺炎疫苗的比例为36.88%。有助于疫苗接种意愿的影响因素为个人收入高、5年内有疫苗接种史;阻碍疫苗接种意愿的影响因素为年龄大、认为流感疫苗接种后不良反应可能性高。[结论]应进一步开展成人疫苗接种的健康教育,对于老年人、COPD患者等特殊人群,政府应提供免费的流感、肺炎疫苗接种,提高此类人群的疫苗接种率。     

女大学生HPV疫苗接种意愿的现状及影响因素

本文综述我国女大学生对HPV疫苗的接种意愿及健康行为相关理论的应用,基于健康生态学模型分析大学生HPV疫苗接种意愿的影响因素,提出信息-动机-行为技巧理论在HPV疫苗行为学中应用的前景,从而进一步探索我国女大学生接种HPV疫苗的行为干预模型。     

基层医务人员流感疫苗接种知信行调查

目的调查基层医务人员流感疫苗接种知信行现况。方法于2016年9月对宁波市江东区5家街道社区卫生服务中心的392名医务人员进行问卷调查,内容包括基本情况、流感相关知识、流感疫苗接种情况和流感疫苗接种意愿,分析流感疫苗接种知信行现况及影响因素。结果发放问卷392份,回收有效问卷389份,有效率为99.23%。医务人员流感相关知识总体知晓率为76.92%,不同最高学历专业、工作科室的医务人员流感相关知识得分差异有统计学意义(均P0.05)。139名医务人员接种过流感疫苗,接种率为35.73%;260名医务人员愿意接种流感疫苗,接种意愿率为66.84%。Logistic回归分析结果显示,工作年限5年(OR:2.61~3.86)和参加健康教育活动(OR=2.24)是接种流感疫苗的促进因素;最高学历专业为非预防医学专业(OR:0.15~0.27)是接种流感疫苗的阻碍因素;流感相关知识得分≥8分(OR=2.95)和接种过流感疫苗(OR=6.09)是愿意接种流感疫苗的促进因素。结论江东区基层医务人员流感相关知识知晓率、流感疫苗接种率和接种意愿率均较低,应加强相关知识的健康教育。     

2型糖尿病患者流感疫苗接种综合干预效果评价

目的评价综合干预模式对社区2型糖尿病(T2DM)患者流感疫苗接种知识和行为的影响。方法采用多阶段分层随机抽样方法选择江北区2个街道(镇)社区管理的T2DM患者,随机分为干预组和对照组,干预组实施以流感相关知识宣传和推荐疫苗接种为主要内容的综合干预,对照组不施加干预措施;干预6个月后,比较两组患者干预前后流感相关知识、疫苗接种意愿和接种率等来评价干预效果。结果干预组506例,对照组502例,应答率分别为92.00%和91.27%。干预后,干预组T2DM患者流感相关知识总知晓率由21.94%提高至58.50%,流感疫苗接种意愿率由11.46%提高至44.27%,上个流感季流感疫苗接种率由4.74%提高至28.26%,推荐他人接种流感疫苗意愿率由9.49%提高至28.26%,提高幅度均大于对照组(P0.05)。结论综合干预模式能够有效提高T2DM患者流感相关知识知晓率、疫苗接种意愿和接种率。     

流感疫苗在高危人群中应用安全性、有效性及接种现状研究新进展

对2020年国内外不同高危人群流感疫苗应用情况发表的相关研究进展进行综述。流感疫苗在高危人群中接种的重要性得到了更多大样本、多中心、高质量循证证据的支持。接种流感疫苗是预防流感最经济有效的措施,目前我国流感疫苗接种率很低,需进一步加大对各类人群流感疫苗接种的科普宣传与教育。建议流感季来临前对研究证据明确的疫苗接种安全有...     

Angst essen Impfbereitschaft auf?

During the influenza pandemic in 2009 individuals had the choice of either receiving a vaccination or running the risk of becoming infected with the pandemic influenza virus A (H1N1). For many individuals knowledge of a likely infection and possibly serious health consequences stood in contrast to a vague fear of the vaccination itself. What has a stronger influence on the decision to be vaccinated: the cognitive estimation of risk or the feeling of risk? Based on data collected during the 2009 influenza A (H1N1) pandemic we tested the relative influence of the cognitive and affective aspects of risk on estimation of the individual willingness to be vaccinated. In doing so we also focused on fear. The results indicate that the feeling of risk had a significant effect on the willingness to be vaccinated. In contrast, the classic, cognitive estimation of a risk was no longer a significant predictor when the feeling of risk was also used to predict the willingness to be vaccinated. A highly felt risk to become infected with influenza A (H1N1) substantially increased the willingness to be vaccinated. A highly felt risk regarding the vaccination, on the other hand, decreased the willingness to be vaccinated. Fear of the vaccination significantly decreased the willingness to be vaccinated even when fear of the spreading disease was also very high. The implications of the results for crisis communications will also be discussed.     

Influenza vaccination uptake among Canadian adults before and during the COVID-19 pandemic: An analysis of the Canadian Longitudinal study on Aging (CLSA)

IntroductionUnderstanding how influenza vaccine uptake changed during the 2020/2021 influenza season compared to previous pre-pandemic seasons is a key priority, as is identifying the relationship between prior influenza vaccination and COVID-19 vaccine willingness.MethodsWe analyzed data from a large, nationally representative cohort of Canadian residents aged 50 and older to assess influenza vaccination status three times between 2015 and 2020. We investigated: 1) changes in self-reported influenza vaccine uptake, 2) predictors of influenza vaccine uptake in 2020/2021, and 3) the association between influenza vaccination history and self-reported COVID-19 vaccine willingness using logistic regression models.ResultsAmong 23,385 participants analyzed for aims 1–2, influenza vaccination increased over time: 14,114 (60.4%) in 2015–2018, 15,692 (67.1%) in 2019/2020, and 19,186 (82.0%; combining those already vaccinated and those planning to get a vaccine) in 2020/2021. After controlling for socio-demographics, history of influenza vaccination was most strongly associated with influenza vaccination in 2020/2021 (adjusted odds ratio [aOR] 147.9 [95% CI: 120.9–180.9]); this association remained after accounting for multiple health and pandemic-related factors (aOR 140.3 [95% CI: 114.5–171.8]). To a lesser degree, those more concerned about COVID-19 were also more likely to report influenza vaccination in fall 2020, whereas those reporting a very negative impact of the pandemic were less likely to get vaccinated. Among 23,819 participants with information on COVID-19 vaccine willingness during the last quarter of 2020 (aim 3), prior influenza vaccination was most strongly associated with willingness to get a COVID-19 vaccine (aOR 15.1 [95% CI: 13.5–16.8] for those who had received influenza vaccine at all previous timepoints versus none).ConclusionsOur analysis highlights the importance of previous vaccination in driving vaccination uptake and willingness. Efforts to increase vaccination coverage for influenza and COVID-19 should target individuals who do not routinely engage with immunization services regardless of demographic factors.     

Influenza and Pneumococcal Vaccination Demand Responses to Changes in Infectious Disease Mortality

Objective. To test the hypothesis that individuals are more likely to receive a vaccination against influenza or pneumonia as the perceived disease threat increases.
Data Sources. This study uses two different national datasets. Individual-level information about the vaccination rates of 38,768 elderly persons are from the Behavioral Risk Factor Surveillance System, 1993–1998. Information on the combined influenza and pneumonia state mortality rates are measured from the Compressed Mortality File.
Study Design. Using both cross-sectional and state fixed-effects panel data estimators, we model an individual's probability of having an influenza or pneumococcal vaccination as a function of the lagged state mortality rate. Multiyear lags are specified in order to estimate the duration of the effect of disease mortality on individual vaccination behavior.
Principal Findings. Results support our hypothesis that influenza vaccination behavior responds positively to disease mortality, even after a one-year lag. We further find that cross-sectional estimators used in previous work yield downward-biased estimates, although even for our preferred panel data models, the estimated effects are small.
Conclusions. The findings indicate that behavioral demand responses can help to limit infectious disease epidemics, and suggest further research on how public awareness campaigns can mediate this disease threat responsiveness behavior.     

Willingness to get vaccinated against influenza,pneumococcal disease,pertussis, and herpes zoster – A pre-COVID-19 exploration among the older adult population

BackgroundOlder adults are at increased risk for adverse health outcomes when having an influenza, pneumococcal disease, pertussis, or herpes zoster infection. Despite the ability of vaccinations to prevent these adverse outcomes, vaccination coverage is low in the European Union. This study aimed to explore the sociodemographic, lifestyle, and health-related characteristics associated with vaccination willingness for these vaccine-preventable diseases.MethodsCross-sectional data from wave 6 (years 2013–2017) of the population-based Doetinchem Cohort Study was analysed, with 3063 participants aged 46–86 years included. The outcome was the self-reported willingness to get vaccinated against influenza, pneumococcal disease, pertussis, and herpes zoster (willing, neutral, not willing). Multinomial logistic regression was used to investigate the socio-demographic, lifestyle and health characteristics associated with vaccination willingness.ResultsFor influenza 36 % was willing to get vaccinated, 35 % was neutral and 28 % was not willing to get vaccinated. The willingness to get vaccinated for the relatively unfamiliar vaccine-preventable diseases was lower: 26 % for pneumococcal disease (neutral: 50 %, not willing: 23 %), 26 % for pertussis (neutral 53 %, not willing: 22 %), and 23 % for herpes zoster (neutral 54 %, not willing: 24 %). A relative lower willingness was found among those 46–64 years old (compared to those 65 years or older). Women, having a high SES, being employed and having a good health were all associated with lower willingness to get vaccinated, which was the case for all vaccine-preventable diseases.ConclusionsOlder adults were generally more willing to get vaccinated against influenza than for the three less familiar diseases. Characteristics of those less willing may be used to improve strategies to increase vaccination coverage. Additional studies are needed to investigate the willingness to get vaccinated during and after the COVID-19 pandemic that may have changed the feel of urgency for vaccination.     

The impact of influenza on the health and health care utilisation of elderly people

Despite intensive research, influenza viruses still present one of the major causes of respiratory disease throughout the world. The elderly population and those individuals considered "at risk" due to presenting co-morbidity are especially vulnerable to influenza infection; this is evident from increased rates of morbidity and mortality in these populations during winter epidemic periods. Successful vaccination campaigns have targeted these groups over the last few years, providing protection to an increasing number of susceptible individuals. However, during periods of influenza virus activity there are still seasonal pressures put on both primary and secondary health care services. In the event of a serious influenza epidemic or pandemic, these burdens could jeopardise health care provision to at risk populations. In this report we discuss current issues surrounding the impact of influenza on the health care utilisation of elderly people.     

Willingness to pay and financing preferences for COVID-19 vaccination in China

BackgroundThe COVID-19 pandemic has caused significant diseases and economic burdens in the world. Vaccines are often considered as a cost-effective way to prevent and control infectious diseases, and the research and development of COVID-19 vaccines have been progressing unprecedently. It is needed to understand individuals’ willingness to pay (WTP) among general population, which provides information about social demand, access and financing for future COVID-19 vaccination.ObjectiveTo investigate individuals’ WTP and financing mechanism preference for COVID-19 vaccination during the pandemic period in China.MethodsDuring March 1–18, 2020, we conducted a network stratified random sampling survey with 2058 respondents in China. The survey questionnaires included out-of-pocket WTP, financing mechanism preference as well as basic characteristics of the respondents; risk perception and impact of the COVID-19 pandemic; attitude for future COVID-19 vaccination. Multivariable Tobit regression was used to determine impact factors for respondents’ out-of-pocket WTP.ResultsThe individuals’ mean WTP for full COVID-19 vaccination was CNY 254 (USD 36.8) with median of CNY 100 (USD 14.5). Most respondents believed that governments (90.9%) and health insurance (78.0%) needed to pay for some or full portions of COVID-19 vaccination, although 84.3% stated that individuals needed to pay. Annual family income, employee size in the workplace, and whether considering the COVID-19 pandemic in China in a declining trend affected respondents’ WTP significantly.ConclusionThe findings demonstrated the individuals’ WTP for COVID-19 vaccination in China and their preferences for financing sources from individuals, governments and health insurance. And to suggest an effective and optimal financing strategy, the public health perspective with equal access to COVID-19 vaccination should be prioritized to ensure a high vaccination rate.     

The impact of socioeconomic level on influenza vaccination among Italian adults and elderly: a cross-sectional study

OBJECTIVE: To assess the predictive factors of influenza vaccination among Italian adults, focusing on socioeconomic differences. METHODS: A cross-sectional study was carried out using interview and self-reported data on 102,095 subjects aged 25-89 years from the national survey "health conditions and health care services use" conducted in Italy in 1999-2000. Analyses were stratified by age and multiple logistic regression models were used to estimate odds ratios (OR) of influenza vaccination. RESULTS: Approximately one in six individuals (17.3%) received an influenza vaccine in the previous 12 months. Older age, poor health status and former smoking were all positively associated with influenza vaccination (P-value<0.05). Lower educated individuals and subjects with manual occupations were less likely to be vaccinated than those better off, with an OR ranging from 0.65 (95% CI 0.55, 0.77) to 0.82 (95% CI 0.71, 0.93). Among individuals aged 65-89 there was no apparent influence of both variables on the likelihood of receiving the influenza vaccine. CONCLUSIONS: Socioeconomic inequalities in influenza vaccine uptake were present among the adults but not among the elderly. Because in Italy the National Health Service provides influenza vaccination to the elderly free of charge, it is possible that this policy attenuated the socioeconomic differential.     

General vaccination willingness and current vaccination status in relation to clinical and psychological variables in patients with multiple sclerosis

BackgroundInfections can have a significant impact on morbidity and mortality in multiple sclerosis (MS) patients. Therefore, vaccinations are of immense importance. If vaccination willingness is to be increased, possible influencing factors should be identified. The aim of the present study was to investigate the status of active immunisation in MS patients in association with sociodemographic, clinical-neurological, psychopathological and personality variables using the NEO-Five Factor Inventory, the Temperament and Character Inventory-Revised and the Hospital Anxiety and Depression Scale.MethodFour hundred and four MS patients from two German neurological hospitals were examined for their vaccination attitudes, in detail, the general willingness to vaccinate and the current vaccination status of mumps, measles and rubella (MMR) as well as tetanus and influenza. We also looked at the current level of disability in relation to the current vaccination status, as well as possible associated personality and psychopathological variables.ResultsPatients with a complete MMR vaccination status were significantly younger and those with a complete influenza vaccination status were significantly older than those with related incomplete vaccination status. Tetanus vaccination status completeness did not differ depending on age and did not show substantial association with personality scores. However, influenza vaccination completeness was associated with differences in personality and psychopathological variables; extraversion, openness, novelty seeking, harm avoidance and anxiety. A reported general vaccination willingness was significantly correlated with the current completeness of tetanus and influenza vaccinations. Novelty seeking, persistence, extraversion, agreeableness, conscientiousness and neuroticism were found associated with an increased vaccination willingness. Anxiety and depression were not related to general vaccination willingness.ConclusionsNo specific personality trait could be defined on its own in relation to general vaccination willingness or complete vaccination status. Younger patients should be made more aware of influenza vaccination. Reasons for rather low vaccination rates need to be further investigated.     

A spatial analysis of the determinants of pneumonia and influenza hospitalizations in Ontario (1992-2001)

Previous research on the determinants of pneumonia and influenza has focused primarily on the role of individual level biological and behavioural risk factors resulting in partial explanations and largely curative approaches to reducing the disease burden. This study examines the geographic patterns of pneumonia and influenza hospitalizations and the role that broad ecologic-level factors may have in determining them. We conducted a county level, retrospective, ecologic study of pneumonia and influenza hospitalizations in the province of Ontario, Canada, between 1992 and 2001 (N=241,803), controlling for spatial dependence in the data. Non-spatial and spatial regression models were estimated using a range of environmental, social, economic, behavioural, and health care predictors. Results revealed low education to be positively associated with hospitalization rates over all age groups and both genders. The Aboriginal population variable was also positively associated in most models except for the 65+-year age group. Behavioural factors (daily smoking and heavy drinking), environmental factors (passive smoking, poor housing, temperature), and health care factors (influenza vaccination) were all significantly associated in different age and gender-specific models. The use of spatial error regression models allowed for unbiased estimation of regression parameters and their significance levels. These findings demonstrate the importance of broad age and gender-specific population-level factors in determining pneumonia and influenza hospitalizations, and illustrate the need for place and population-specific policies that take these factors into consideration.     

Determinants of willingness to pay for self-paid vaccines in China

Background

While vaccines not covered by China's Expanded Program on Immunization can be received voluntarily with out-of-pocket payment, the uptake of self-paid vaccines in China is low.

Objective

To investigate willingness to pay (WTP) for self-paid vaccines and its determinants in China.

Methods

We interviewed 2160 randomly selected households with children 0–3 years old, in 108 communities from three provinces in 2013. A bidding game method was used to elicit WTP for two self-paid vaccines: 7-valent pneumococcal conjugate vaccine and influenza vaccine. We conducted multivariate linear regressions to determine factors affecting the WTP.

Results

Median WTP for pneumococcal conjugate vaccine and influenza vaccine were Chinese Yuan 200 and 60 (10 US Dollars). 92% and 55% of respondents, respectively were not willing to pay the market price for these two vaccines. Lower price barrier and higher ability to pay were associated with higher WTP. Those with better vaccine or disease-related knowledge, higher perceived vulnerability and severity of diseases were willing to pay more. However, perceived effectiveness and safety barriers to vaccination had no significant effects on the WTP. Recommendations from peers and healthcare providers increased the WTP. Fathers and grand parents of children had a higher WTP than their mothers. The WTP decreased with age, but was not affected by education and occupation.

Conclusions

The majority of individuals, in our study, were not willing to pay the market price for self-paid vaccines against high-burden diseases in China. The economic barriers to vaccination should therefore be removed to increase the demand. Region-specific information about disease burden, fiscal capacity and cost-effectiveness is important for the development of local financing policy in order to cover vaccination costs. Interventions targeting psychosocial factors, such as health education and communication with providers and peers, could also be effective in increasing the uptake of these vaccinations.